MEDICARE: DIARRA AYSHA AGUIRRE NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	697591	NY
2	363LF0000X	Family Nurse Practitioner	F339988	NY

General Provider Information

NPI Number	:	1730556341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIARRA AYSHA AGUIRRE NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	ADVANTAGECARE PHYSICIANS, PC
Second Line	:	55 WATER STREET 2ND FLOOR CRED DEPT
City	:	NEW YORK
State	:	NY
Zip	:	10041-0004
Country	:	US
Telephone Number	:	646-680-2888
Fax Number	:	516-542-5556

Provider Business Practice Location Address
First Line	:	570 GRAND STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-2757
Country	:	US
Telephone Number	:	212-674-8210
Fax Number	:	212-533-1812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	10/03/2023

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